The U.S. military suffered more casualties from suicide than from combat last year. A staggering 349 service members took their own lives in 2012 according to a Pentagon report on active-duty suicides. These numbers, when compared to 229 troops killed in combat over the same period from the Washington Post’s tally, compelled U.S. Navy Lt. Darryl Diptee to seek out the underlying causes of military suicides and, ultimately, to develop a solution of his own to assist in combating the problem.

While attending the “Coping with Wicked Problems” course at the Naval Postgraduate School (NPS), Diptee was challenged by his professor, Dr. Nancy Roberts, to find and identify a wicked problem, or a catastrophic issue seemingly impossible to solve, and create a solution.

“Darryl identified military suicides as an issue on which he wanted to focus for the wicked problems course,” she said. “His interest in the topic grew as the course progressed and continued to the point where he actually came up with a solution that he is now prototyping,” said Roberts.

Diptee lists Roberts' enthusiasm, energy and passion along with a concerning Time magazine cover feature, as inspiration for his efforts.

“I saw the Time magazine cover story that stated, ‘One per Day’ – referencing the military suicide rate. I was deeply troubled by the statistics of the article, which went on to state that [at the time] the suicide rate for veterans was one per 80 minutes,” said Diptee. “The article, my own military experience with fragmented mental health care, and Dr. Roberts' ‘Coping with Wicked Problems’ course proved to be very influential when I created the Chronic Emotional Atrophy (CEA) theory.”

The CEA theory offers an explanation as to why people in the U.S. military could become suicidal. As Diptee describes it, CEA occurs when a person’s brain rapidly loses the ability to process emotions due to prolonged exposure to an emotionally-sterile environment.

“My CEA theory states that suicidal symptoms [in the military] are environmentally induced due to the machine-like, stone-faced bravado that occurs in military culture … leaving little room for any honest expression of personal feelings or emotions,” said Diptee.

Macho-man syndrome negatively stigmatizes the expression of emotion and rewards emotional-numbness, he added.

“Expressing emotion and feelings is jokingly seen as a characteristic of the weak in the military,” he continued. “Further enforcing the bottling up of emotions, which can have detrimental effects leading to CEA.”

As Diptee continued his research into the root causes of service member suicides, he began noticing a correlation between their underlying symptoms, and those of patients who experience frontal lobe damage.

“I created the CEA theory during the research process after discovering numerous symptomatic similarities between medical patients who suffered frontal lobe brain damage [due to surgery, accidents etc.] and suicidal military members with physically intact brains,” said Diptee.

Following a Naval Postgraduate School course in how to approach seemingly insurmountable problems, Lt. Darryl Diptee, left, was inspired to create the Emotional Vitality Assistant, a smartphone application that provides service members with immediate access to mental health resources. The app is garnering increasing attention within the Navy, including a recent demonstration to Master Chief Petty Officer of the Navy (MCPON) Michael D. Stevens, right. (Photo courtesy Lt. Darryl Diptee)

According to an article published in the Journal of Consulting and Clinical Psychology, a patient who has experienced frontal lobe trauma may know the appropriate response to a situation, but present an inappropriate response to that same situation in action. Emotions that are felt may not be expressed in the face or voice. As an example, someone who is feeling happy would not smile, and his or her voice would be absent of the thought emotion. The person may also exhibit excessive, unwarranted displays of emotion.

“CEA is thought to slowly strip away the most delicate human qualities, including the ability to experience deeply embedded and secondary emotion,” said Diptee. “This is a service member with a frontal lobe that basically doesn't work right, essentially emotionally numb.”

High-profile cases have lent credence to the research in question. Professional football player Junior Seau, who committed suicide two years ago, suffered from chronic brain damage due to multiple head injuries over his 20-year career, including the scaring of Seau’s frontal lobe. In addition, a correlation can be inferred between the machismo atmosphere exhibited in professional sports, to what one would encounter in military culture.

In following interviews, Seau’s ex-wife says that during the last years of his life, he suffered from random mood swings, depression, forgetfulness, insomnia and detachment. All consistent symptoms of frontal lobe damage, and are in line with Diptee’s CEA theory.

The discovery led the former NPS student to ask a simple fundamental question, why do military personnel with physically-intact brains exhibit many of the same symptoms as medical patients with frontal lobe brain damage? And more importantly, are there correlations in how they can be treated?

Diptee quickly found the answer in a straightforward therapeutic approach. And he quickly set out to provide a resource to help fight the effects of CEA for deployed troops, creating the Emotional Vitality Assistant (EVA) model using a special application design process developed by Stanford University.

“EVA extends the physical mental health therapy space to the virtual space,” said Diptee. “It is a smartphone application that was designed to combat CEA by promoting continual personal expression in a private, confidential, virtual space with a counselor.

“It is believed that if service members continually and honestly express their deepest emotions in a safe non-threatening arena with a counselor, that the symptoms that lead to suicidal thoughts will not occur,” he added.

Diptee’s EVA application is grounded in a concept of therapy knows as Frontal Lobe Stimulation (FLS).

“FLS strengthens emotional and mental health by helping a service member exercise emotional functioning of the [frontal lobe region of the] brain,” said Diptee. Exercising emotional function can be anything from writing or vocally expressing personal feelings, creating art or human bonding, he said.

“EVA will help fight the effects of CEA for deployed troops,” Diptee added, “because it is socially acceptable, technically feasible and economically viable.”

Since its creation, Diptee’s application and the supporting research has garnered a lot of attention, giving him the ear of military leaders and the private sector.

“I was invited to present EVA at the Naval Development Warfare Command's IdeaFest in Hampton Roads, Va.,” said Diptee. “EVA received many positive responses and showed potential for use with the Navy Expeditionary Combat Command's Embedded Health Care Provider (eHCP) program.”

Diptee has also received recognition from the offices of Senators Tim Kaine and John McCain, expressing interest in the EVA concept and requesting more information.

“The Navy Times requested an interview on my research and the EVA concept, focusing on innovation in the Navy and the people behind those innovations,” he said. “The EVA concept was recently shared with some flag staff, and it is currently under review.”

And it couldn’t be a better time for Diptee’s research. In light of Suicide Prevention Month, Secretary of Defense Chuck Hagel released a message to the forces emphasizing the Department of Defense’s ongoing support of research into the epidemic.

“The Department of Defense has invested more than $100 million into research on the diagnosis and treatment of depression, bipolar disorder and substance abuse, as well as interventions for relationship, financial and legal issues – all of which can be associated with suicide,” said Hagel in the statement.

The challenge of military suicides is wicked indeed, and having found his solution to a wicked problem, the timing couldn’t have been better than the present for Diptee’s research.

“I believe that my research can help arm our military with the knowledge and tools to keep themselves mentally healthy and emotionally stable,” said Diptee.

Posted September 10, 2013

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